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目的探讨上颌窦底冲压提升技术在上颌后牙区种植修复中的应用效果和技术特点。方法1998年7月至2004年7月,共完成122例上颌窦底冲压提升种植修复病例。男性48例,女性74例,平均年龄46·5岁(20~69岁),共植入157枚种植体。随访5年以上21例,3年以上41例,2年以上27例,1年以上33例,平均随访29·7个月。观察方法为临床检查和X线检查。患者均因上颌后牙种植区牙槽嵴顶至上颌窦底之间的剩余骨高度在8~11mm,无法植入足够长度的种植体,因而采用上颌窦底冲压法局部提升上颌窦底骨板及黏骨膜,提升幅度为2~5mm。术中未使用任何骨移植材料,同期植入种植体。若种植体植入时的扭力>0·25N·m,则行一段式种植体直接安装愈合基台,3~4个月后进行种植义齿修复;若种植体植入时的扭力<0·25N·m,则采取埋入式种植技术,3~4个月后再行Ⅱ期种植体暴露手术及修复。结果122例中有12例上颌窦黏骨膜穿破,但在观察期内未发生上颌窦炎等并发症。157枚种植体均获得良好的骨结合并已完成种植修复,至2005年10月为止,无种植体脱落,患者对修复效果满意。结论上颌窦底冲压提升种植修复技术安全、简便、易行;手术创伤小,可在上颌后牙区种植修复病例中选用。
Objective To investigate the application effect and technical characteristics of maxillary sinus floor pressing in the reconstruction of maxillary posterior teeth. Methods From July 1998 to July 2004, a total of 122 cases of maxillary sinus puncture lift prosthesis rehabilitation cases were completed. There were 48 males and 74 females, with an average age of 46.5 years (range, 20-69 years). A total of 157 implants were implanted. 21 cases were followed up for more than 5 years, 41 cases were over 3 years, 27 cases were over 2 years and 33 cases were over 1 year. The average follow-up was 29.7 months. Observation methods for clinical examination and X-ray examination. Patients were maxillary posterior dental implants alveolar crest to maxillary sinus floor between the remaining bone height of 8 ~ 11mm, implants can not be implanted enough length, so the use of maxillary sinus puncture local elevation of the maxillary sinus bone plate And mucoperiosteal, increase the rate of 2 ~ 5mm. No bone graft material was used in the surgery and implants were implanted in the same period. If the implants when the implant torque> 0 · 25N · m, the line of one-stage implant directly installed healing abutments, 3 to 4 months after the implant denture repair; implant implants, the torque of <0.25N · M, then take the embedded planting technology, 3 to 4 months after the second phase implant surgery and repair. Results Of 122 cases, 12 cases of maxillary sinus perforation, but no complications such as maxillary sinusitis occurred during the observation period. 157 implants were well bone union and have been completed implant repair, until October 2005, no shedding, the patient satisfaction with the repair. Conclusion The maxillary sinus at the end of stamping to enhance implant safety, simple, easy to operate; surgical trauma is small, can be selected in the reconstruction of the maxillary posterior teeth implant area.